Unprecedented demand on health services prompts ‘difficult choices’

Lindsay Pantry

Health chiefs in part of North Yorkshire say they will need to evaluate every service they commission to plug a growing shortfall in its budget amid “unprecedented” demand.

Harrogate and Rural District Clinical Commissioning Group (CCG) say although its NHS funding has not been cut, the rise in demand for health services and increasing costs is “outstripping” the money available for services.

The pressures of a growing and ageing population has caused a “significant increase” in demand for all types of local health services against a fixed NHS budget, the CCG said.

Plans are already in place to plug the £8.4m shortfall for the next financial year, 2016/17, but with costs continuing to rise, it is preparing further ways in which it can bridge the budget gap, including proposals to stop providing ‘over the counter’ medicines like paracetamol, which last year cost the NHS locally £260,000 to prescribe. Paracetamol and other painkillers are widely available in supermarkets and at local chemists and cost around 1p per tablet, compared to 3p per tablet on the NHS, the CCG said.

Governing body member at the CCG, Rick Sweeney, said: “As an organisation we have a number of difficult choices to make about what is affordable for the whole of our local population against an ever increasing demand for access to health services.

“We are reviewing all areas of spend including the services we purchase, the medicines prescribed, outpatient appointments and operations.

“Getting medicine on prescription costs much more than buying over the counter due to the time doctors and local pharmacists take when dealing with appointments, handling prescriptions and dispensing medication. Last year, over 3m items were prescribed to patients across Harrogate and the rural district at a cost of over £25m.”

Examples of increased demand on health services across Harrogate include a 2.7 per cent increase in the number of people attending A&E in the same three month period of April to June from 2015 to 2016 - equating to an additional £125,000 cost not planned for.

The same comparative period also saw a 14 per cent increase in the number of knee procedures at an additional cost of £160,000.

Chief officer at the CCG, Amanda Bloor, appealed directly to residents of the Harrogate district to “play their part” in addressing the challenge.

She said: “Like many neighbouring CCGs across North Yorkshire, we are facing unprecedented challenges as demand from an ageing and growing population increases.

“It is important that everyone using the NHS appreciates the pressures it faces through growing demand and cost and takes responsibility for using it most effectively so we can help secure high quality local health services.

“The CCG is working to identify as many efficiency savings as it can. This will mean a renewed focus on self-care and healthy lifestyle choices by individuals and may include reduction or withdrawal of certain services that do not improve outcomes.

“Everyone is aware that public services and specifically the NHS are under significant pressure, and I would encourage local people to help the CCG ensure we can continue to deliver the services needed for local people within the budget we are given from Government.

“We will be working closely with our partners including Healthwatch North Yorkshire to determine how we can secure services within the funding available.”